Centering Adolescents' Voices: Informing a Middle School-Based Well-Being Intervention
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| Title: | Centering Adolescents' Voices: Informing a Middle School-Based Well-Being Intervention |
|---|---|
| Language: | English |
| Authors: | Sarah Kiefer (ORCID |
| Source: | Psychology in the Schools. 2025 62(8):2630-2642. |
| Availability: | Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us |
| Peer Reviewed: | Y |
| Page Count: | 13 |
| Publication Date: | 2025 |
| Document Type: | Journal Articles Reports - Research |
| Education Level: | Junior High Schools Middle Schools Secondary Education |
| Descriptors: | Adolescents, Middle School Students, Well Being, Intervention, Mental Health, Health Promotion, Psychology, Program Evaluation, Program Effectiveness, Mental Health Programs, Program Implementation, Student Attitudes |
| DOI: | 10.1002/pits.23488 |
| ISSN: | 0033-3085 1520-6807 |
| Abstract: | ABSTRACT Many youth seek and receive mental health treatment in schools, yet research on their perceptions of these interventions remains uncommon. This qualitative study explored how student perspectives on social validity informed the ongoing implementation and evaluation of the Well-Being Promotion Program (WBPP), a Tier 2 positive psychology intervention in middle schools. The study was conducted during the initial years of a larger ongoing randomized control trial evaluating the WBPP's effectiveness. Themes from student interviews conducted during Year 1 of the larger study were used to inform implementation supports during Year 2 to enhance student acceptability. Thirty student interviews were conducted during Year 2 of the larger study. Overall, most students found the intervention content, group process, and delivery to be acceptable. The findings identified ways to further enhance the implementation of the WBPP and indicate accessing student voice is an important way to engage in program implementation and evaluation of a middle school-based intervention. Recommendations are provided for those interested in centering student voices regarding social validity to inform program implementation and evaluation. |
| Abstractor: | As Provided |
| Entry Date: | 2025 |
| Accession Number: | EJ1477351 |
| Database: | ERIC |
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| FullText | Links: – Type: pdflink Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHj0k_4E0hTGH8RJwT4gCJyBsGNe_WN95AvKlDbXJGqwxwHPU6Wr0Rx6p021-Z3IDQaHAAAA4jCB3wYJKoZIhvcNAQcGoIHRMIHOAgEAMIHIBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDE00u0GBbErDxNChBwIBEICBmp-r6o8M8tsMih5B9r28Q0GKph9-3Dl1DqenP37Re7hzNRmfbfTKh0zd8qHx2Ee23fon6gpqJ9IhBQsNJ8FVrfzeZwJiWSoxCkFWZ3IyGxf2dnKPh_btkl745RYcHZM4kzgJmyWWLowHhVfSZNAGrGHGLgpNs4pihwp4-GwcSkl0XXuQZb5GBFeb1SOh_WHrW9z4sWRaSTopmJU= Text: Availability: 1 Value: <anid>AN0186727905;pis01aug.25;2025Jul21.06:39;v2.2.500</anid> <title id="AN0186727905-1">Centering Adolescents' Voices: Informing a Middle School‐Based Well‐Being Intervention </title> <p>Many youth seek and receive mental health treatment in schools, yet research on their perceptions of these interventions remains uncommon. This qualitative study explored how student perspectives on social validity informed the ongoing implementation and evaluation of the Well‐Being Promotion Program (WBPP), a Tier 2 positive psychology intervention in middle schools. The study was conducted during the initial years of a larger ongoing randomized control trial evaluating the WBPP's effectiveness. Themes from student interviews conducted during Year 1 of the larger study were used to inform implementation supports during Year 2 to enhance student acceptability. Thirty student interviews were conducted during Year 2 of the larger study. Overall, most students found the intervention content, group process, and delivery to be acceptable. The findings identified ways to further enhance the implementation of the WBPP and indicate accessing student voice is an important way to engage in program implementation and evaluation of a middle school‐based intervention. Recommendations are provided for those interested in centering student voices regarding social validity to inform program implementation and evaluation.</p> <p>Summary: Incorporating student perspectives on social validity informed the ongoing implementation and evaluation of a Tier 2 positive psychology intervention in middle schools called the Well‐Being Promotion Program (WBPP).Most students who participated in the WBPP found its content, group process, and delivery acceptable.Most students who participated in the WBPP described the group sessions as engaging, group leaders as understanding and responsive, and the intervention as helpful for improving their moods and building relationships.</p> <p>Keywords: acceptability; positive psychology intervention; social validity; student voice</p> <hd id="AN0186727905-2">Introduction</hd> <p>Many youth receive school‐based mental health services (Simon et al. [<reflink idref="bib46" id="ref1">46</reflink>]). However, research on their acceptability remains limited (Silva et al. [<reflink idref="bib45" id="ref2">45</reflink>]), despite calls for further exploration (Hanley [<reflink idref="bib18" id="ref3">18</reflink>]). Acceptability, also referred to as social validity, is the extent to which individuals view the content and procedures of an intervention as satisfactory, intervention goals as significant, and intervention effects as satisfying (Wolf [<reflink idref="bib58" id="ref4">58</reflink>]). Accessing students' voices regarding social validity can inform intervention implementation (Cook et al. [<reflink idref="bib8" id="ref5">8</reflink>]), promote program sustainability (Moir [<reflink idref="bib36" id="ref6">36</reflink>]), and enhance the promotion of positive youth outcomes (Yeager et al. [<reflink idref="bib59" id="ref7">59</reflink>]). Student voice refers to the practice of providing students with an active role in identifying needs in their schools and providing input on specific practices and programs (Giraldo‐García et al. [<reflink idref="bib15" id="ref8">15</reflink>]). Engaging in student voice activities may benefit youth mental health (Ballard and Ozer [<reflink idref="bib1" id="ref9">1</reflink>]) and are well‐aligned with school‐based mental health interventions (O'Malley et al. [<reflink idref="bib40" id="ref10">40</reflink>]).</p> <p>School psychologists have a professional responsibility to ensure that school‐based interventions are viewed as important, appropriate, and satisfying for individuals involved in implementation (National Association of School Psychologists (NASP) [<reflink idref="bib39" id="ref11">39</reflink>]). Not only is acceptability a tool to increase the effectiveness of interventions, but it is also an ethical responsibility to properly seek out and utilize the input of those who engage in and receive school mental health services. Thus, the current study explored student perspectives on the acceptability of a Tier 2 positive psychology intervention in middle schools (i.e., the Well‐Being Promotion Program [WBPP]). The findings can be used to inform ongoing program implementation supports and future iterations of the intervention.</p> <hd id="AN0186727905-3">School Mental Health Interventions That Increase Student Subjective Well‐Being</hd> <p>Best practices in school mental health services involve a multi‐tiered system of support. This includes interventions that (a) increase well‐being indicators and (b) decrease markers of emotional and behavioral problems (Lazarus et al. [<reflink idref="bib27" id="ref12">27</reflink>]). The WBPP is a small group, school‐based multicomponent positive psychology intervention (PPI) that has been shown to increase student life satisfaction and positive affect among middle school students (Roth et al. [<reflink idref="bib42" id="ref13">42</reflink>]; Suldo et al. [<reflink idref="bib48" id="ref14">48</reflink>]). It includes positive activities that have shown promise in promoting students' subjective well‐being (SWB; Tejada‐Gallardo et al. [<reflink idref="bib50" id="ref15">50</reflink>]). Positive activities focus on enhancing gratitude, kindness, optimism, hope, and the use of signature character strengths (Suldo [<reflink idref="bib47" id="ref16">47</reflink>]). The WBPP provides students with opportunities to socialize, learn from positive role models, and build positive relationships (Keperling et al. [<reflink idref="bib25" id="ref17">25</reflink>]). Small groups are intended to be co‐facilitated by school‐based mental health practitioners and/or trainees.</p> <p>The current study explored student participants' perceptions of the acceptability of the intervention content, group process, and delivery. Information on whether students find the WBPP to be acceptable has been limited to brief written comments in prior research. For instance, on a feedback form completed during the last session of the WBPP, students reported they enjoyed and were interested in the sessions (Roth et al. [<reflink idref="bib42" id="ref18">42</reflink>]). Students noted that their most preferred and important aspects included experiencing positive growth across the intervention (57%), receiving tangible incentives for participating in sessions and completing homework (33%), engaging in group sessions (29%), enjoying specific activities they learned (19%), and receiving help from their group leaders (14%). For the least preferred or important aspects of the intervention, students noted homework (38%), missing class (14%), and completing a lengthy survey to identify signature character strengths (10%). In addition, two students reported the program's time‐limited nature and one student mentioned that peers were reluctant to share their thoughts in the group. For improving the program, 48% of students noted they would not change anything. The section was left blank by 10% of students. Three students suggested assigning less homework; one wanted to meet more frequently, one wanted to meet during lunch or outside of school, and one wanted to practice skills learned more intensely. Recent research provides initial support for the acceptability of the WBPP for middle school students, with a focus on cultural relevance (Shum et al. [<reflink idref="bib44" id="ref19">44</reflink>]). The novel contribution of the current study is that we accessed student voices through structured interviews with participants in the WBPP and used their input on acceptability to understand their experiences with the program and support implementation.</p> <hd id="AN0186727905-4">Student Voice and School Mental Health Interventions</hd> <p>Utilizing student voices aligns with the idea that students have unique views on their schooling, students deserve the attention and responses of adults, and students should have a role in making decisions that impact their education (Cook‐Sather [<reflink idref="bib10" id="ref20">10</reflink>]; Mitra [<reflink idref="bib34" id="ref21">34</reflink>]; Ozer et al. [<reflink idref="bib41" id="ref22">41</reflink>]). It is important that students are afforded opportunities to provide input and that this results in meaningful changes (Cook‐Sather [<reflink idref="bib9" id="ref23">9</reflink>]). Student‐voice strategies include actively involving youth by encouraging their ideas and promoting collaborative decision‐making (Giraldo‐García et al. [<reflink idref="bib15" id="ref24">15</reflink>]; Mitra [<reflink idref="bib35" id="ref25">35</reflink>]). These strategies are well‐aligned with the dual mental health model and school‐based mental health interventions (O'Malley et al. [<reflink idref="bib40" id="ref26">40</reflink>]). According to the dual model of mental health, well‐being is considered the presence of psychological assets (e.g., life satisfaction and positive affect) and a lack of psychopathology (Suldo and Shaffer [<reflink idref="bib49" id="ref27">49</reflink>]). Incorporating student voices may be a promising strategy to inform and improve positive psychology school‐based interventions such as the WBPP.</p> <p>There are benefits to incorporating student‐voice strategies in school‐based initiatives (Giraldo‐García et al. [<reflink idref="bib15" id="ref28">15</reflink>]). For instance, student voices may provide information adults cannot fully access on their own (Mitra [<reflink idref="bib31" id="ref29">31</reflink>]). Youth‐based benefits include enhanced experiences in school, including greater autonomy and respect, as well as increased engagement and belonging (Mitra [<reflink idref="bib33" id="ref30">33</reflink>]; Ozer et al. [<reflink idref="bib41" id="ref31">41</reflink>]; Voight and Nation [<reflink idref="bib54" id="ref32">54</reflink>]; Yeager et al. [<reflink idref="bib59" id="ref33">59</reflink>]; Zeldin et al. [<reflink idref="bib60" id="ref34">60</reflink>]). Further, student voice activities may benefit youth mental health by affording opportunities for self‐expression and contributing to meaningful improvements, improving perceived control and empowerment (Ballard and Ozer [<reflink idref="bib1" id="ref35">1</reflink>]). Youth who participate in student voice activities are often more aware of mental health supports, more willing to seek help for themselves and their peers, and have more positive attitudes toward mental health (O'Malley et al. [<reflink idref="bib40" id="ref36">40</reflink>]). However, these benefits often depend on the quality of students' relationships with adults and a sense of emotional safety (Zeldin et al. [<reflink idref="bib60" id="ref37">60</reflink>]).</p> <p>Student voice is especially important for adolescents who do not find school meaningful (Mitra [<reflink idref="bib33" id="ref38">33</reflink>]) or who have experienced marginalization or oppression (e.g., racial and ethnic minorities, low socioeconomic status, language‐diverse youth, etc.). For these youth, sharing their perspectives and experiences may serve as a protective factor for mental health and psychological well‐being (Hope et al. [<reflink idref="bib19" id="ref39">19</reflink>]; O'Malley et al. [<reflink idref="bib40" id="ref40">40</reflink>]). Student voice strategies are often included in school‐based interventions aimed at improving adolescents' well‐being, such as culturally adapted social and emotional learning approaches (O'Malley et al. [<reflink idref="bib40" id="ref41">40</reflink>]). Several social‐emotional interventions that incorporated student voice in secondary schools improved diverse adolescents' psychological adjustment (e.g., Belgrave et al. [<reflink idref="bib2" id="ref42">2</reflink>]; Castro‐Olivo [<reflink idref="bib6" id="ref43">6</reflink>]).</p> <hd id="AN0186727905-5">The Current Study</hd> <p>The current study answered the following research question: how do student perspectives on social validity inform the ongoing implementation and evaluation of the WBPP, a Tier 2 positive psychology intervention in middle schools? Although research has explored the importance of social validity and student voice, little has been done to connect these concepts to implementation science (Kelly and Perkins [<reflink idref="bib24" id="ref44">24</reflink>]). An exception is Shum et al. ([<reflink idref="bib44" id="ref45">44</reflink>]), who adapted the WBPP to meet the diverse needs of middle school students, emphasizing the importance of cultural relevance and social validity. Their research identified the need to explore how student feedback can be gathered and used to inform processes to support school‐based intervention delivery. Informed by these findings, the current study explored student perceptions of the WBPP to understand how student feedback can inform implementation supports. By listening to student voices, the study aims to improve the WBPP's relevance and effectiveness, ensuring it meets the unique needs of the student population it serves.</p> <hd id="AN0186727905-6">Methods</hd> <p>The study followed qualitative research procedures outlined by Merriam ([<reflink idref="bib30" id="ref46">30</reflink>]) and was conducted during the initial years of a larger ongoing randomized control trial (RCT) evaluating the WBPP's effectiveness. Student data from Year 1 of the larger study informed implementation during Year 2 to enhance student engagement[<reflink idref="bib1" id="ref47">1</reflink>].</p> <hd id="AN0186727905-7">Participants</hd> <p>Data included 30 student interviews randomly selected from 128 interviews conducted at five middle schools in Year 2 of the larger study. The 128 students were from a larger group of 188 students who completed the WBPP and post‐intervention survey. Student demographics are as follows: 47% from a Northeastern state, 53% from a Southeastern state; 7% in fifth grade, 60% in sixth grade, 13% in seventh grade, and 20% in eighth grade; 53% female, 40% male, 7% nonbinary; 63% White, non‐Hispanic, 20% Hispanic, 3% Black, 3% Asian, and 10% multiracial or other identity. Of these students, eight students (27%) reported high acceptability (average score of greater than 4.5 out of 5 on the Treatment Evaluation Inventory‐ Short Form [TEI‐SF]), 16 students (53%) reported moderate acceptability (average score of 3 to 4.5 on the TEI‐SF), and six students (20%) reported low acceptability (average score less than 3 on the TEI‐SF).</p> <hd id="AN0186727905-8">Materials</hd> <p></p> <hd id="AN0186727905-9">Intervention</hd> <p>The Well‐Being Promotion Program (WBPP; Suldo [<reflink idref="bib47" id="ref48">47</reflink>]) aims to enhance life satisfaction, elicit positive emotions, and strengthen interpersonal relationships among children and adolescents. The multi‐faceted positive psychology intervention consists of ten weekly sessions, supplemented by monthly maintenance sessions, each approximately 45 min in duration and formatted for small group facilitation. Each session begins with a review and reflection on previous topics covered and between‐session practice assignments. After this, new concepts and skills are introduced along with in‐session practice. The session concludes with a homework assignment aimed at applying positive activities and learned skills to various life domains (e.g., school, home, community). The WBPP also incorporates a caregiver component, beginning with a 30‐min informational session followed by weekly handouts that recap the sessions and provide strategies to support positive activities at home. In recent implementations, co‐leaders participated in weekly coaching sessions between the core sessions to support the group process and student engagement. See Shum et al. ([<reflink idref="bib44" id="ref49">44</reflink>]) for a description of the group leader's initial training and coaching. For more details on WBPP sessions, refer to Suldo ([<reflink idref="bib47" id="ref50">47</reflink>]).</p> <hd id="AN0186727905-10">Intervention Modifications</hd> <p>Based on feedback from students who participated in the WBPP during Year 1, we identified strategies for group leaders (i.e., interventionists—school‐mental health providers [SMHPs] and study staff) to enhance student engagement with the intervention content during Year 2. First, we encouraged group leaders to use more student‐centered instructional strategies and adjust pacing. Group leaders were also encouraged to be flexible when it did not impact the integrity of the intervention (e.g., program focus, content, and homework as described in the leader manual; Suldo [<reflink idref="bib47" id="ref51">47</reflink>]). For example, group leaders may choose to use different ice breakers for rapport building or provide students with writing accommodation as needed (e.g., drawing instead of writing things they are grateful for, using sentence starters to describe the best version of their future self, using a letter template to write a gratitude letter).</p> <p>Second, leaders were encouraged to share their personal experiences and to use culturally inclusive and relatable examples for students (Shum et al. [<reflink idref="bib44" id="ref52">44</reflink>]) when facilitating the WBPP's positive activities. All leaders had a chance to practice the positive activities during the initial training through a self‐paced journal. We also encouraged leaders to provide ample time for discussions to learn more about each student. Third, we encouraged group leaders to present the between‐session homework assignments to enhance students' motivation and engagement. Leaders framed homework as "take‐home challenges" to decrease its association with academic homework that may have negative connotations for students. Leaders also clarified that take‐home challenges were not tied to academic grades and emphasized the need for continuous practice of positive activities.</p> <p>Lastly, some students voiced that the program's purpose was initially unclear. In response, we developed a recruitment flyer to share with students invited to participate in the study after screening. The flyer included student quotes about their experience with the WBPP to help clarify the program's goals, illustrate potential benefits, and minimize potential stigma associated with participating. During the invitation process, we also emphasized that the WBPP strives to improve well‐being and promote self‐discovery rather than treat depression.</p> <hd id="AN0186727905-11">Interview Protocol</hd> <p>This study used a semi‐structured interview to capture students' voices and their views of the WBPP's social validity. The interview protocol included questions that aimed to identify essential aspects of social validity (Wolf [<reflink idref="bib58" id="ref53">58</reflink>]), focusing on the importance of intervention goals, appropriateness of intervention content, and importance of intervention outcomes. The interview protocol was developed iteratively throughout Years 1 and 2 of the larger study. The protocol starts with telling students that the purpose of the interview is to elicit feedback on the WBPP. The voluntary nature of the interview was emphasized, and students could stop at any time without any penalties. Students were encouraged to share their honest opinions. Students were also told that there were no right or wrong answers and that their responses would remain confidential. Next, students were asked about their overall thoughts regarding the WBPP, including what they liked the most and the least. Following this, students were encouraged to share how the WBPP fit or did not fit with their culture, as well as their unique life experiences and values. Lastly, students shared their final thoughts on the WBPP and recommendations for change (for the full interview protocol, see Shum et al. [<reflink idref="bib44" id="ref54">44</reflink>].</p> <hd id="AN0186727905-12">Procedure</hd> <p></p> <hd id="AN0186727905-13">Student Screening and Recruitment</hd> <p>In the early fall, we screened students' SWB in five public middle schools across two states in the U.S. that served a diverse body of students. Based on the results, we invited eligible students to participate using individual and small group meetings to allow students to ask questions and reduce stigmatization around mental health supports. We enrolled 45% of students invited to participate (i.e., written caregiver consent and student assent). We randomly assigned students to participate in the WBPP in the fall (intervention group) or the spring (waitlist control group). A week before the intervention, we collected participants' baseline data on mental health. We stratified students based on their Student Life Satisfaction Scale scores (Huebner [<reflink idref="bib20" id="ref55">20</reflink>]) and grade level. We then randomized into conditions (intervention or waitlist control group).</p> <hd id="AN0186727905-14">Intervention Implementation</hd> <p>The intervention condition for each school was split into one to two small groups per grade level, with a total of twenty‐two groups and six to thirteen students per group. District SMHPs implemented the WBPP alongside study staff (post‐doctoral fellows and graduate students). Students who were absent could have a make‐up session during the same or next week. The 28 group leaders were 71% SMHPs (12 school counselors, two school social workers, two school psychologists, and four professionals such as behaviorist or mentor), and 29% study staff (six graduate students and two post‐doctoral fellows). Group leaders were mostly female (82% female, 18% male) and White (85% White, 4% Black, and 11% Hispanic).</p> <p>Regarding Year 2 retention, of the 199 randomly assigned student participants in the intervention group, 184 were in the study for the 10 core sessions, and 188 filled out the post‐intervention assessment battery. About 93% of participants were present for all 10 core sessions. Students attended six to 10 sessions (range), with a mean of 9.8 sessions (average). There was a 96% average fidelity to the protocol per session (SD = 1.34) across all five schools (range: 94% to 99% by school).</p> <hd id="AN0186727905-15">Data Collection</hd> <p>Students participated in an exit interview with a research team member within a week of post‐intervention survey‐based data collection. Interviews were conducted by members who were not in their WBPP group(s). This allowed students to candidly share their experiences with the WBPP. Participants received a $5 gift card. Interviews were an average of 23.6 min (range: 12 to 41 min). We used an online service (rev. com) to transcribe audio files. Next, seven research team members heard the audio files and reviewed the transcriptions. Errors were fixed (e.g., spelling or punctuation) to ensure transcripts accurately portrayed the interview. The same team formatted the transcripts to improve readability during an additional round of edits.</p> <hd id="AN0186727905-16">Data Analyses</hd> <p>We followed Braun and Clarke's ([<reflink idref="bib5" id="ref56">5</reflink>]) six‐step data analysis process for thematic analysis: (<reflink idref="bib1" id="ref57">1</reflink>) familiarization of the data; (<reflink idref="bib2" id="ref58">2</reflink>) generation of initial codes; (<reflink idref="bib3" id="ref59">3</reflink>) combining codes into potential themes; (<reflink idref="bib4" id="ref60">4</reflink>) reviewing themes; (<reflink idref="bib5" id="ref61">5</reflink>) defining and naming themes; and (<reflink idref="bib6" id="ref62">6</reflink>) producing a report. The research team consisted of ten members (four faculty, two postdoctoral fellows, and four graduate students). Groups of two to three members analyzed 30 randomly selected interviews using NVivo. First, members independently listened to the audio files and read the transcripts multiple times to become familiar with the data. Second, they highlighted meaningful units of analysis in the transcripts and generated initial codes. Then, each group met to discuss preliminary results and develop a codebook. After that, the full team shared codes and added descriptions and examples to the codebook. Rotating coding pairs, the pairs independently coded the interviews and then held consensus meetings to discuss and resolve discrepancies. Third, we generated summary statements for each code, which were used for theme generation. Fourth, we reviewed themes by methodically reading statements within and across participants to determine commonalities and discrepancies and to highlight common experiences and suggestions for implementation. The themes identified were higher frequency responses mentioned by at least two participants. We repeated this process until we reached saturation (i.e., no new ideas arose from coding). Fifth, we finalized the theme names and definitions and their alignment with corresponding codes and data. Lastly, we reported the findings and included compelling quotes.</p> <hd id="AN0186727905-17">Trustworthiness of the Data</hd> <p>Four strategies were used to ensure the trustworthiness of the findings, including credibility, transferability, dependability, and confirmability (Shenton [<reflink idref="bib43" id="ref63">43</reflink>]). For credibility, we included multiple perspectives during data collection, data analysis, and confirmation of findings to ensure the data was accurate and representative. Second, team members were experienced with delivering the WBPP, familiar with the culture of participating schools, and quickly established rapport with students. Third, students were encouraged to be honest about sharing their thoughts in the interview. For transferability, we provided a thick, rich description of the data, along with sufficient evidence in the form of quotes to support themes. Further, the team achieved saturation in the data analysis as well as identified and discussed variability in the findings, including non‐examples. Regarding dependability, we maintained an in‐depth description of how the study was conducted, including data collection and analysis. Lastly, we took steps to ensure confirmability and minimize potential researcher bias. Team members engaged in reflexivity to acknowledge their positionality and biases throughout the study (Berger [<reflink idref="bib3" id="ref64">3</reflink>]). Members also wrote memos to foster reflexivity and analytical thinking during data collection and analysis. Further, members analyzed transcripts independently and rotated small groups to prevent drift and allow for various perspectives (Tracy [<reflink idref="bib53" id="ref65">53</reflink>]).</p> <hd id="AN0186727905-18">Results</hd> <p>We identified three themes regarding students' perceptions of the intervention, including the content, group process, and delivery. We identified two sub‐themes regarding students' perceptions of the intervention <emph>content</emph>. First, most students had a positive perception of the program and believed it was beneficial in improving their mood, although some reported neutral feelings or felt bored and believed the program did not affect their mood. Second, many students liked the take‐home challenges and found them useful to apply the positive activities to their lives. However, some perceived homework as too much or were sometimes too busy to complete it. We found two sub‐themes for students' perceptions of the intervention <emph>group process</emph>. First, students viewed group leaders as relatable and responsive. Second, most students felt connected to each other and were engaged, although a few felt they did not "fit in" and did not engage. For students' perceptions of the intervention <emph>delivery</emph>, most students enjoyed the group size, pacing, and timing, although students differed in their preferred times to schedule group sessions. See Table 1 for a description of themes and sub‐themes.</p> <p>1 Table Student qualitative findings for student perceptions of the social validity of the well‐being promotion program.</p> <p> <ephtml> &lt;table&gt;&lt;thead valign="bottom"&gt;&lt;tr valign="bottom"&gt;&lt;th&gt;Theme&lt;/th&gt;&lt;th align="center"&gt;Subtheme&lt;/th&gt;&lt;th align="center"&gt;Description&lt;/th&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody valign="top"&gt;&lt;tr&gt;&lt;td&gt;Acceptability of Intervention Content&lt;/td&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Positive Perceptions of the Program&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Most students had a positive perception of the program and believed it was beneficial in improving their mood, although some students reported neutral feelings or felt bored and believed the program did not affect their mood.&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Take&amp;#8208;Home Challenges Useful but Overwhelming in Addition to Academic Homework&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Many students liked the take&amp;#8208;home challenges and found them useful to apply the positive activities to their own lives, but some perceived homework as too much or overwhelming and were sometimes too busy to complete it.&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td&gt;Acceptability of Intervention Process&lt;/td&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Relatable and Responsive Group Leaders&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Students viewed group leaders as relatable and responsive.&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Student Connection and Engagement in Small Groups&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Most students felt connected to each other and engaged in group sessions, but a few students felt they did not "fit in" with their group members and did not engage in discussion.&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td&gt;Acceptability of Intervention Delivery&lt;/td&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Positive Perceptions of the Delivery&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Most students enjoyed the group size, pacing, and timing, although some students differed on preferred times to schedule group sessions.&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt; </ephtml> </p> <hd id="AN0186727905-19">Acceptability of Intervention Content</hd> <p>Overall, students viewed the intervention content as acceptable, and most shared positive statements about their impressions of the program. Most students also reported that the program was beneficial in promoting well‐being, although some reported more neutral feelings about the program's impact. Regarding the utility of take‐home challenges, many students reported seeing the value of them in their own lives. However, others said they were too busy to complete them or had too much academic homework to complete the take‐home challenges.</p> <hd id="AN0186727905-20">Positive Perceptions of the Program</hd> <p>Most students viewed the program positively, describing it as "good" or "fun," and believed the program was beneficial in improving their mood. For example, one student stated:</p> <p>I think it was fun. It was exciting that I got to do all the things, and some of the activities we did made me a more positive person and kind of made me happier and nicer to other people.</p> <p>(Student A)</p> <p>Another student elaborated on why they perceived the program as fun and improving their mood:</p> <p>It was fun because we got to learn more about happiness, hope, [and] gratitude. We also got to do activities like using your signature strengths in a new way. It was really fun to learn about how to use them in a different way. Even the gratitude visit; it made me honestly feel better when I gave it to my dad and my grandmother.</p> <p>(Student B)</p> <p>A third student reported they enjoyed the program and experienced an increase in happiness and a boost in relationships, aligning with the goals of the intervention,</p> <p>"Just by doing the acts of kindness, you can make someone else's day, and helping someone else can make you feel that much better".</p> <p>(Student C)</p> <p>However, some students reported mixed or neutral feelings, felt bored, or believed the program did not affect their mood. Student B stated, "<emph>Some parts could get boring at times when we were learning about some things, but overall, it was actually really fun and good</emph>." Student D stated, <emph>"It has good intentions behind it, but I was kind of bored most of the time."</emph> An additional student expressed, "<emph>I don't know. I felt like it was supposed to help me, like I don't know, be more happy, but it didn't, and I don't feel like I changed at all"</emph> (Student E).</p> <hd id="AN0186727905-21">Take‐Home Challenges Useful but Can be Overwhelming in Addition to Academic Homework</hd> <p>Many students voiced take‐home challenges were helpful in understanding the program content. Students valued the practice activities and appreciated applying them to their lives. One student shared:</p> <p>I feel like for the take‐home challenges, I think it was good because it let students build the habit of practicing the skills we learned here. And I really liked it because it gave us time to practice our skills and maybe even interpret them into our daily lives.</p> <p>(Student F)</p> <p>Another student shared that the take‐home challenge helped them to achieve desired outcomes, such as a decrease in stress levels:</p> <p>I like the take‐home challenges because it's something to work on and something that could actually really improve, and I feel like I've really improved since I started this program. I feel like I started to sleep easier; I felt like I just feel less stressed than I did at the beginning of the year because eighth grade is really stressful, so I feel like this program really helped me out.</p> <p>(Student G)</p> <p>Students appreciated incentives for completing take‐home challenges and having no direct consequences for not doing the homework. Students reported feeling overwhelmed with academic homework but were not stressed by the take‐home challenges. One student shared, <emph>"I liked that you had freedom to do things. If you didn't want to do it, you didn't have to"</emph> (Student H). Some students voiced that being busy may have hindered their completion of take‐home challenges. Student B shared, "<emph>Some of the things I already knew, so honestly kind of relearning it was boring for me. And also, some things I couldn't get done because I'm busy most of the week, so I really couldn't get those done</emph>." Another student shared, <emph>"Probably in between the sessions don't give big, not like big, you know, like a lot of work because sometimes people don't have the time to do it or they're busy or whatever"</emph> (Student H). A few students struggled to remember to do take‐home challenges but would have completed them if they had remembered.</p> <hd id="AN0186727905-22">Acceptability of Intervention Group Process</hd> <p>Overall, students felt accepted in their groups, which helped them establish positive relationships and practice purposeful activities to help improve their subjective well‐being. Two sub‐themes were identified regarding students' perceptions of the acceptability of the intervention group process: (<reflink idref="bib1" id="ref66">1</reflink>) group leaders were viewed as relatable and responsive, and (<reflink idref="bib2" id="ref67">2</reflink>) students felt connected and engaged in their group.</p> <hd id="AN0186727905-23">Relatable and Responsive Group Leaders</hd> <p>Students shared their thoughts regarding group dynamics and relationships formed within the group. Students shared that they had positive interactions and viewed group leaders as relatable and responsive. Students voiced that their leaders tried to understand what was going on in students' lives and shared their own personal experiences with the group. One student said, "<emph>The group leaders really helped by being so nice and inviting, welcoming, and they shared a lot about their lives, which helped us share about our lives"</emph> (Student F). Another student shared:</p> <p>I think they brought themselves down to our level of how they felt in school and how much pressure they felt when they were us. And they went through the effort of trying to remind us that change is always possible and that they changed, so we definitely can. They reminded us that we were smart, that we were special. The character strengths activity, they reminded us that we all have our strengths and that we can all use them in different ways.</p> <p>(Student C)</p> <p>A third student voiced,</p> <p>"It was just nice to talk to somebody that could just relate so easily to you [group leader] because they've been through middle school, so they understand how stressful it could be."</p> <p>(Student G)</p> <p>Students who viewed leaders as relatable often felt they could talk to them. One student expressed,</p> <p>"It didn't feel like she was a teacher trying to teach us. It felt like we could just relate to her and talk to her."</p> <p>(Student I)</p> <p>"They wanted to make me feel comfortable. It was a safe spot. I could talk about whatever I wanted that I wouldn't normally tell somebody."</p> <p>(Student M)</p> <p>A third student reflected on how their leaders helped them to feel comfortable in a group,</p> <p>"I liked the teachers that taught us this because it just made me feel more comfortable around more people, and it just taught me more ways to be happier and not always feel bad about myself".</p> <p>(Student N)</p> <p>Students reflected on how positive relations with group leaders and a supportive group climate helped to support the aims of the intervention. One student shared:</p> <p>I liked the ways that they [group leaders] thought about the individual ways that make us happy and how they gave us ways to help with the ways that we couldn't. Because they said there were ways that we couldn't change, and then there were ways that we did, and they gave us ways to change some things to make us happier.</p> <p>(Student C)</p> <p>Another student reflected:</p> <p>I liked all the lessons, and I liked basically the teachers that have taught us this because it just made me feel more comfortable around more people, and it just taught me more ways to be happier and not always feel bad about myself.</p> <p>(Student O)</p> <p>Thus, participants felt leaders were relatable and helped them feel comfortable in their group.</p> <hd id="AN0186727905-24">Student Connection and Engagement in Small Groups</hd> <p>Students voiced they felt connected to peers in their group because of perceived commonalities, pre‐existing friendships, and engaging in positive activities. This may have helped students have a positive experience and perceive the program as beneficial in improving their mood. Regarding having perceived commonalities with peers, one student reflected:</p> <p>We would talk about all the stuff that we're relatable with, like the character strengths and everything, like how I said some kids have fairness, same as me.</p> <p>(Student J)</p> <p>Feeling connected to peers aligned with students having a clear, shared understanding of the group's purpose. One student said,</p> <p>"We're all different in our own ways, but we all had the same goal, which was to try and be happier and improve our well‐being."</p> <p>(Student I)</p> <p>Another student echoed the sentiment,</p> <p>"It was nice that everyone was there, and we all wanted to improve our mental health [and] happiness.".</p> <p>(Student G)</p> <p>Students who had pre‐existing friendships in their group tended to engage in discussions and got to know others as time went on. One student shared,</p> <p>"I feel like I did fit in because I had a lot of friends in here."</p> <p>(Student K)</p> <p>Other students shared that they enjoyed getting to know people in the group who they may not have known well previously, as Student P shared:</p> <p>You would get to know a bit more about yourself and other people [who] might not be from your same grade, or it could be that you haven't known yet or have known but haven't known a lot about them.</p> <p>Students felt connected to one another when engaging in positive activities, which helped to foster their motivation to practice positive activities. This is illustrated in the following quote:</p> <p>"[I feel] connected, probably everyone's sharing their stories and stuff and everyone else's life experiences and all their signature strengths. I liked what they were working on, and I felt like, "Wow." Maybe I should work on that next.".</p> <p>(Student G)</p> <p>Another student shared how it was beneficial to engage in group discussions characterized by trust and respect:</p> <p>The fact that we all felt open to talk about our experiences over time and that we all felt that none of us made fun of each other or made us feel insecure or bad about what happened to us, and that we kind of all just helped each other understand how we felt.</p> <p>(Student C)</p> <p>However, a few students voiced they did not "fit" in with their peers and did not engage in group discussion. One student explained why they were not friends with and did not talk to other students in their group,</p> <p>"Just cause we have different personalities, and some don't like to share, some do, some are bold, some aren't, some are shy, some aren't. And I don't know them really well, and they kind of go their own paths."</p> <p>(Student L)</p> <hd id="AN0186727905-25">Acceptability of Intervention Delivery</hd> <p>Overall, students reflected positively on the program delivery, including the group size, timing, and pacing of sessions. Some students differed on preferred times to hold sessions. Students reported enjoying their group size (8–10 students) and felt like it allowed them to feel comfortable. One student stated,</p> <p>"I liked the number of people. I felt like it wasn't too much, but it wasn't too little. And I liked that everyone tried to get involved."</p> <p>(Student G)</p> <p>Students mostly approved of the session length of approximately 45 min (30‐35 in some schools), noting that this amount of time allowed them to learn the content and engage in discussions. Student G voiced,</p> <p>"They [timing] were all just right. I feel like it was nice because you have more than enough time... And if somebody else wanted to share more things, they'd have that extra time."</p> <p>Others voiced that although the timing and pacing were not optimal, they found the sessions beneficial. For instance, Student Q reflected:</p> <p>I think the meetings were paced kind of slow, but I think...I opened up a lot, and I think that was also beneficial and it helped me get more in‐depth with the stuff. I think that the meetings were kind of a bit short, but obviously it's only going to last one period.</p> <p>Some students enjoyed the timing and pacing of sessions and did not miss skipping class. One student shared:</p> <p>They [group sessions] were honestly really good. It wasn't too long of a meeting where I would... Yes, I would miss a little bit of science because, say, we were trying to do more discussions, and we went overtime a little bit. I would miss a little bit of science, but I'm fine with that.</p> <p>(Student B)</p> <p>However, others expressed concerns about missing classes. One student was concerned about missing a flexible scheduling period that could be used to complete academic assignments,</p> <p>"The thing I liked the least was just having to go, especially when I needed to make up assignments in flex‐block and stuff like that".</p> <p>(Student D)</p> <hd id="AN0186727905-26">Discussion</hd> <p>To address the scarcity of student voice in program implementation and evaluation in the literature, this study explored students' perceptions of social validity during the initial years of a larger ongoing randomized control trial (RCT) to examine the effectiveness of the WBPP (Suldo [<reflink idref="bib47" id="ref68">47</reflink>]), a Tier 2 positive psychology intervention in middle schools. Overall, most students perceived that the intervention content, group process, and delivery were acceptable to them. The findings indicate accessing student voice is a valuable and important way to engage in ongoing program evaluation and improvement. Although we are unable to implement changes to the intervention content during the multi‐year RCT, the findings of this study have informed our interventionist delivery and logistics planning and can inform future iterations of the intervention. We provide program improvement suggestions that may benefit those who wish to utilize the WBPP and implement changes rooted in student voices (see Table 2). Lastly, limitations and future directions are discussed.</p> <p>2 Table Recommendations for future iterations of the well‐being promotion program.</p> <p> <ephtml> &lt;table&gt;&lt;thead valign="bottom"&gt;&lt;tr valign="bottom"&gt;&lt;th&gt;Theme&lt;/th&gt;&lt;th align="center"&gt;Subtheme&lt;/th&gt;&lt;th align="center"&gt;Recommendation&lt;/th&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody valign="top"&gt;&lt;tr&gt;&lt;td&gt;Acceptability of Intervention Content&lt;/td&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Positive Perceptions of the Program&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Identify students who may have neutral perceptions of the program or are bored, aim to make group&amp;#8208;based interventions more engaging for them.&lt;/p&gt;&lt;/list-item&gt;&lt;list-item&gt;&lt;p&gt;Address psychopathology and well&amp;#8208;being together, especially for students who are not engaged, not feeling the benefits, or are not engaging due to factors that may need to be addressed by other interventions.&lt;/p&gt;&lt;/list-item&gt;&lt;list-item&gt;&lt;p&gt;Understand that although students might not feel the content is beneficial now, they may find it helpful later in life.&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Take&amp;#8208;Home Challenges Useful but Overwhelming in Addition to Academic Homework&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Be mindful of students' academic homework and perceived stressors during middle school.&lt;/p&gt;&lt;/list-item&gt;&lt;list-item&gt;&lt;p&gt;Provide reminders as well as support and scaffolds for students to complete the take&amp;#8208;home challenges.&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td&gt;Acceptability of Intervention Process&lt;/td&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Relatable and Responsive Group Leaders&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Relate to students by understanding what is going on in their lives.&lt;/p&gt;&lt;/list-item&gt;&lt;list-item&gt;&lt;p&gt;Be responsive by creating an inclusive and welcoming space.&lt;/p&gt;&lt;/list-item&gt;&lt;list-item&gt;&lt;p&gt;Listen to students and model ways to engage in discussion, especially for those who are reluctant to do so.&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td /&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Student Connection and Engagement in Small Groups&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Help students to feel safe to share about their lives, connect to others, and engage in discussion.&lt;/p&gt;&lt;/list-item&gt;&lt;list-item&gt;&lt;p&gt;Foster positive peer interactions in group.&lt;/p&gt;&lt;/list-item&gt;&lt;list-item&gt;&lt;p&gt;Promote engagement by facilitating leader&amp;#8208; and student&amp;#8208;focused activities and interactions&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td&gt;Acceptability of Intervention Delivery&lt;/td&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Positive Perceptions of the Delivery&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;td&gt;&lt;list list-type="Bullet"&gt;&lt;list-item&gt;&lt;p&gt;Consider student input regarding the group size, pacing, and scheduling of group sessions.&lt;/p&gt;&lt;/list-item&gt;&lt;list-item&gt;&lt;p&gt;Preplan group formation to accommodate student and staff preferences regarding scheduling and group processes.&lt;/p&gt;&lt;/list-item&gt;&lt;/list&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt; </ephtml> </p> <hd id="AN0186727905-27">Acceptability of Intervention Content</hd> <p>Although most students enjoyed the program and found it beneficial, some had neutral or negative perceptions of the program. This aligns with research indicating adolescents experience decreased motivation and increased disengagement in school (e.g., not paying attention, not participating, being bored, or not enjoying learning; Fredricks et al. [<reflink idref="bib14" id="ref69">14</reflink>]). Further, students' honest and mixed feedback aligns with past research on the WBPP (Roth et al. [<reflink idref="bib42" id="ref70">42</reflink>]). Given the decline in intervention effectiveness among adolescents (Yeager et al. [<reflink idref="bib59" id="ref71">59</reflink>]), accessing student voices may allow schools to respond to students' developmental needs (Wigfield et al. [<reflink idref="bib57" id="ref72">57</reflink>]) and enhance implementation efforts and student engagement (Yeager et al. [<reflink idref="bib59" id="ref73">59</reflink>]).</p> <p>Findings suggest that group leaders can improve engagement by identifying students with lower interest early and tailoring intervention strategies to their needs. This may include adapting content to students' developmental levels (Malti et al. [<reflink idref="bib29" id="ref74">29</reflink>]), promoting student's social needs (e.g., belonging, respect, and avoiding social stigma; Tomova et al. [<reflink idref="bib51" id="ref75">51</reflink>]; Yeager et al. [<reflink idref="bib59" id="ref76">59</reflink>]), and incorporating students' unique lived experiences (Shum et al. [<reflink idref="bib44" id="ref77">44</reflink>]). Researchers and practitioners can also be mindful of the importance of addressing psychopathology and well‐being together, especially for students who are not engaged or feeling the benefits due to factors that need to be addressed by other interventions (Doll et al. [<reflink idref="bib12" id="ref78">12</reflink>]). Lastly, it is important to understand that although students might not feel the content is beneficial now, they may find it helpful later when experiencing stressors or symptoms of mental health problems.</p> <p>The finding that most students found the take‐home challenges useful is promising, as it indicates that most students applied the skills taught in the program to their daily lives, aligning with the goals of the WBPP intervention (Suldo [<reflink idref="bib47" id="ref79">47</reflink>]). However, students who are too busy or perceive take‐home challenges as overwhelming may experience stress that can be detrimental to their mental health and school adjustment (Goldstein et al. [<reflink idref="bib16" id="ref80">16</reflink>]; Grant et al. [<reflink idref="bib17" id="ref81">17</reflink>]; van Loon et al. [<reflink idref="bib28" id="ref82">28</reflink>]). As early adolescents may experience increased levels of stress as a result of physical, social, and school transitions (Washington [<reflink idref="bib56" id="ref83">56</reflink>]), it may be especially important to consider ways to be mindful of middle school students' academic homework and perceived stressors.</p> <p>The findings can inform the acceptability of interventions that use homework or take‐home challenges to help students practice skills learned in sessions in other contexts. Group leaders can frame between‐session homework as beneficial (i.e., stating 'the why') and provide positive consequences for completion. Leaders can also be mindful of students' academic workload and perceived stressors when identifying ways for youth to apply skills to their daily lives. By providing reminders as well as support and scaffolds, group leaders can help students complete take‐home challenges alongside other school demands. Leaders can also teach students cognitive and emotional regulation skills by monitoring student progress, reserving time to practice skills, and emphasizing growth and improvement (Murray and Rosanbalm [<reflink idref="bib38" id="ref84">38</reflink>]).</p> <hd id="AN0186727905-28">Acceptability of Intervention Group Process</hd> <p>Students' positive relationships with group leaders and peers may have helped them to engage in small group sessions. This aligns with research indicating having supportive relationships with adults in school is related to greater student engagement (Murray [<reflink idref="bib37" id="ref85">37</reflink>]; Wang and Holcombe [<reflink idref="bib55" id="ref86">55</reflink>]). Perceiving group leaders as relatable and feeling connected to peers may help to support adolescents' socioemotional and developmental needs. Specifically, adolescents desire authentic relationships with adults and peers characterized by warmth, trust, autonomy, and respect (Jackson and Goossens [<reflink idref="bib21" id="ref87">21</reflink>]; Yeager et al. [<reflink idref="bib59" id="ref88">59</reflink>]). Adolescence is also a time of increased sensitivity to peer influence and threats to status and respect, including rejection (Blakemore [<reflink idref="bib4" id="ref89">4</reflink>]; Choudhury et al. [<reflink idref="bib7" id="ref90">7</reflink>]; Tomova et al. [<reflink idref="bib51" id="ref91">51</reflink>]). Thus, supporting positive relationships and students' socioemotional and developmental needs may benefit student engagement and program effects targeting mental health (Kehoe et al. [<reflink idref="bib22" id="ref92">22</reflink>]; Zeldin et al. [<reflink idref="bib60" id="ref93">60</reflink>]).</p> <p>The study's findings can inform future program improvement and implementation efforts.</p> <p>Specifically, group leaders can relate to students by understanding what is going on in their lives, especially those who have had unique lived experiences. Leaders can be responsive by creating an inclusive and welcoming space. This may be done by leaders listening to students and modeling ways to engage in discussion, especially for those who are reluctant to do so.</p> <p>Leaders can foster student connection and engagement by helping students feel safe to share about their lives, connect to others, and engage in discussion. By sharing their lived experiences of engaging in positive activities and encouraging students to share as well, leaders may help youth find commonalities among peers in their group. Leaders can foster positive peer interactions by modeling prosocial behaviors, minimizing evaluation, being responsive to student comments and questions, and allowing students to voice their perspectives and experiences (Fjermestad et al. [<reflink idref="bib13" id="ref94">13</reflink>]; Fredricks et al. [<reflink idref="bib14" id="ref95">14</reflink>]). This may serve as a protective factor for mental health and psychological well‐being for students who do not find school meaningful (Mitra [<reflink idref="bib33" id="ref96">33</reflink>]) or who have experienced marginalization or oppression (O'Malley et al. [<reflink idref="bib40" id="ref97">40</reflink>]). Lastly, leaders can promote engagement by facilitating leader‐ and student‐focused activities and interactions (Mitra [<reflink idref="bib32" id="ref98">32</reflink>]; Voight and Nation [<reflink idref="bib54" id="ref99">54</reflink>]).</p> <p>In the current study, students reported feeling more comfortable, safe, and less nervous when they knew other students in their group and when they shared commonalities with each other. Given the exploratory nature of the study, we were unable to determine whether this was due to having relatively homogenous groups with pre‐existing friendships or the intervention. We recommend future research investigate the influence of homogeneous versus heterogeneous groups for school‐based Tier 2 interventions. We encourage school personnel to seek input from SMHPs, teachers, and students regarding group preferences and preplan group formation to help improve dynamics. Leaders may benefit from support and training to strengthen group dynamics skills. We provided leaders with initial training and ongoing coaching to strengthen group dynamics and improve student engagement. We encourage the continuation of these supports.</p> <hd id="AN0186727905-29">Acceptability of Intervention Delivery</hd> <p>Students' perceptions regarding the acceptability of the delivery may help to inform and improve the implementation of the WBPP. School personnel can take into consideration student input regarding the group size, pacing, and scheduling to increase student acceptability of the intervention. For instance, forming small groups with about eight students can allow students to interact with peers as well as feel comfortable and less pressured to share. Weekly sessions (approximately 45 min) can give groups sufficient time to engage in the content and discussions. To improve students' acceptability of scheduling and group processes, school personnel can preplan group formation to accommodate student and staff preferences (Crespi et al. [<reflink idref="bib11" id="ref100">11</reflink>]). Implementing school‐based interventions is a complex endeavor that can have certain challenges (e.g., time restrictions, pressure to make changes quickly, lack of staff or resources, and existing policies and procedures; Moir [<reflink idref="bib36" id="ref101">36</reflink>]). Those interested in accessing student voices to inform intervention implementation, evaluation, and improvement can start small and achieve success early by starting with existing programs and school structures and seeking out publicly accessible, practical resources (Mitra [<reflink idref="bib34" id="ref102">34</reflink>]; O'Malley et al. [<reflink idref="bib40" id="ref103">40</reflink>]).</p> <hd id="AN0186727905-30">Limitations and Future Directions</hd> <p>The findings are promising regarding incorporating student voice to inform program evaluation and improvement. However, this study has its limitations. Only 68% of students in the WBPP participated in the interviews; they do not represent all students in the intervention. In addition, student interview responses may have been influenced by the school context (Komulainen [<reflink idref="bib26" id="ref104">26</reflink>]). We took steps to mitigate this and ensure students' privacy and safety by conducting individual interviews with a study staff who was not their group leader. We also encouraged students to be open about their least favorite or beneficial aspects of the program.</p> <p>Future studies can explore ways to access ongoing, real‐time feedback from students regarding program acceptability and use it to inform and tailor school‐based intervention delivery to meet student needs. Shum et al. ([<reflink idref="bib44" id="ref105">44</reflink>]) adapted the WBPP to meet the diverse needs of middle school students. Their research identified the need to explore how continuous student feedback can be gathered and used to inform school‐based interventions. For instance, staff and school personnel can find ways for students to express their perspectives through interviews, focus groups, and anonymous online surveys throughout an intervention. Group leaders can collect informal feedback regarding students' perceptions of the program content, group dynamics, and delivery during weekly sessions. Student voice can also be accessed by students actively participating in the decision‐making process, engaging in youth participatory action research (Voight and Nation [<reflink idref="bib54" id="ref106">54</reflink>]), and serving as leaders of change (Toshalis and Nakkula [<reflink idref="bib52" id="ref107">52</reflink>]). Using multiple ways to access student voice may allow schools to collect feedback from diverse youth. This may have implications for improving acceptability for schools serving students who experience barriers to mental health care or are traditionally underserved, as well as improving program outcomes. Lastly, this study provided preliminary support for using student voices regarding the social validity of the WBPP based on post‐intervention data. Additional research is needed to examine causal links between student acceptability and program outcomes.</p> <hd id="AN0186727905-31">Conclusion</hd> <p>The purpose of this qualitative study was to explore how student perspectives on social validity informed the implementation and evaluation of the Well‐Being Promotion Program (WBPP; Suldo [<reflink idref="bib47" id="ref108">47</reflink>]), a Tier 2 positive psychology intervention in middle schools. Overall, students perceived the WBPP's intervention content, group process, and delivery as acceptable. The findings identified ways to further enhance the implementation of the WBPP and indicate accessing student voice is an important way to engage in program implementation and evaluation of a middle school‐based intervention. The findings inform recommendations for practitioners and future research directions for those interested in centering student voices regarding social validity to inform program evaluation and improvement for school‐based interventions.</p> <hd id="AN0186727905-32">Acknowledgments</hd> <p>This study was supported by the Institute of Education Sciences, U.S. Department of Education, through Grant R305A200035 to the University of South Florida and the University of Massachusetts Amherst. The opinions expressed are those of the authors and do not represent the views of the Institute or the U.S. Department of Education. Aside from support from the aforementioned research grant, each author declares that they have no additional conflict of interest. We acknowledge the contributions of other research team members, including Nicolette Bauermeister, Van Le, Hallie Lothrop, and Kimiya Vaezi.</p> <ref id="AN0186727905-33"> <title> Footnotes </title> <blist> <bibl id="bib1" idref="ref9" type="bt">1</bibl> <bibtext> Student data from Year 1 of the larger study included a subset of 30 student interviews from a larger group of 68 interviews conducted at three middle schools (Shum et al. [44]). The 68 students who participated in an interview were from a larger group of 98 students in two states who completed the WBPP and surveys. Students responded to 12 survey questions, including items modified from the Treatment Evaluation Inventory – Short Form (TEI‐SF), to gauge their perspectives on social validity post‐intervention (Kelley et al. [23]).</bibtext> </blist> </ref> <ref id="AN0186727905-34"> <title> References </title> <blist> <bibtext> Ballard, P. J., and E. J. Ozer. 2016. 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American Journal of Community Psychology 61, no. 3–4 : 358 – 371. https://doi.org/10.1002/ajcp.12231.</bibtext> </blist> </ref> <aug> <p>By Sarah Kiefer; Jacqueline Blass; Sarah Fefer; Kai Zhuang Shum; Kristen Mahony‐Atallah; Shannon Suldo and John Ferron</p> <p>Reported by Author; Author; Author; Author; Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib46" firstref="ref1"></nolink> <nolink nlid="nl2" bibid="bib45" firstref="ref2"></nolink> <nolink nlid="nl3" bibid="bib18" firstref="ref3"></nolink> <nolink nlid="nl4" bibid="bib58" firstref="ref4"></nolink> <nolink nlid="nl5" bibid="bib36" firstref="ref6"></nolink> <nolink nlid="nl6" bibid="bib59" firstref="ref7"></nolink> <nolink nlid="nl7" bibid="bib15" firstref="ref8"></nolink> <nolink nlid="nl8" bibid="bib40" firstref="ref10"></nolink> <nolink nlid="nl9" bibid="bib39" firstref="ref11"></nolink> <nolink nlid="nl10" bibid="bib27" firstref="ref12"></nolink> <nolink nlid="nl11" bibid="bib42" firstref="ref13"></nolink> <nolink nlid="nl12" bibid="bib48" firstref="ref14"></nolink> <nolink nlid="nl13" bibid="bib50" firstref="ref15"></nolink> <nolink nlid="nl14" bibid="bib47" firstref="ref16"></nolink> <nolink nlid="nl15" bibid="bib25" firstref="ref17"></nolink> <nolink nlid="nl16" bibid="bib44" firstref="ref19"></nolink> <nolink nlid="nl17" bibid="bib10" firstref="ref20"></nolink> <nolink nlid="nl18" bibid="bib34" firstref="ref21"></nolink> <nolink nlid="nl19" bibid="bib41" firstref="ref22"></nolink> <nolink nlid="nl20" bibid="bib35" firstref="ref25"></nolink> <nolink nlid="nl21" bibid="bib49" firstref="ref27"></nolink> <nolink nlid="nl22" bibid="bib31" firstref="ref29"></nolink> <nolink nlid="nl23" bibid="bib33" firstref="ref30"></nolink> <nolink nlid="nl24" bibid="bib54" firstref="ref32"></nolink> <nolink nlid="nl25" bibid="bib60" firstref="ref34"></nolink> <nolink nlid="nl26" bibid="bib19" firstref="ref39"></nolink> <nolink nlid="nl27" bibid="bib24" firstref="ref44"></nolink> <nolink nlid="nl28" bibid="bib30" firstref="ref46"></nolink> <nolink nlid="nl29" bibid="bib20" firstref="ref55"></nolink> <nolink nlid="nl30" bibid="bib43" firstref="ref63"></nolink> <nolink nlid="nl31" bibid="bib53" firstref="ref65"></nolink> <nolink nlid="nl32" bibid="bib14" firstref="ref69"></nolink> <nolink nlid="nl33" bibid="bib57" firstref="ref72"></nolink> <nolink nlid="nl34" bibid="bib29" firstref="ref74"></nolink> <nolink nlid="nl35" bibid="bib51" firstref="ref75"></nolink> <nolink nlid="nl36" bibid="bib12" firstref="ref78"></nolink> <nolink nlid="nl37" bibid="bib16" firstref="ref80"></nolink> <nolink nlid="nl38" bibid="bib17" firstref="ref81"></nolink> <nolink nlid="nl39" bibid="bib28" firstref="ref82"></nolink> <nolink nlid="nl40" bibid="bib56" firstref="ref83"></nolink> <nolink nlid="nl41" bibid="bib38" firstref="ref84"></nolink> <nolink nlid="nl42" bibid="bib37" firstref="ref85"></nolink> <nolink nlid="nl43" bibid="bib55" firstref="ref86"></nolink> <nolink nlid="nl44" bibid="bib21" firstref="ref87"></nolink> <nolink nlid="nl45" bibid="bib22" firstref="ref92"></nolink> <nolink nlid="nl46" bibid="bib13" firstref="ref94"></nolink> <nolink nlid="nl47" bibid="bib32" firstref="ref98"></nolink> <nolink nlid="nl48" bibid="bib11" firstref="ref100"></nolink> <nolink nlid="nl49" bibid="bib26" firstref="ref104"></nolink> <nolink nlid="nl50" bibid="bib52" firstref="ref107"></nolink> |
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| Header | DbId: eric DbLabel: ERIC An: EJ1477351 AccessLevel: 3 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
| IllustrationInfo | |
| Items | – Name: Title Label: Title Group: Ti Data: Centering Adolescents' Voices: Informing a Middle School-Based Well-Being Intervention – Name: Language Label: Language Group: Lang Data: English – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Sarah+Kiefer%22">Sarah Kiefer</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0001-9532-8890">0000-0001-9532-8890</externalLink>)<br /><searchLink fieldCode="AR" term="%22Jacqueline+Blass%22">Jacqueline Blass</searchLink><br /><searchLink fieldCode="AR" term="%22Sarah+Fefer%22">Sarah Fefer</searchLink><br /><searchLink fieldCode="AR" term="%22Kai+Zhuang+Shum%22">Kai Zhuang Shum</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-0547-9957">0000-0003-0547-9957</externalLink>)<br /><searchLink fieldCode="AR" term="%22Kristen+Mahony-Atallah%22">Kristen Mahony-Atallah</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-8748-5535">0000-0002-8748-5535</externalLink>)<br /><searchLink fieldCode="AR" term="%22Shannon+Suldo%22">Shannon Suldo</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-2173-181X">0000-0002-2173-181X</externalLink>)<br /><searchLink fieldCode="AR" term="%22John+Ferron%22">John Ferron</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-6263-5912">0000-0002-6263-5912</externalLink>) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="SO" term="%22Psychology+in+the+Schools%22"><i>Psychology in the Schools</i></searchLink>. 2025 62(8):2630-2642. – Name: Avail Label: Availability Group: Avail Data: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us – Name: PeerReviewed Label: Peer Reviewed Group: SrcInfo Data: Y – Name: Pages Label: Page Count Group: Src Data: 13 – Name: DatePubCY Label: Publication Date Group: Date Data: 2025 – Name: TypeDocument Label: Document Type Group: TypDoc Data: Journal Articles<br />Reports - Research – Name: Audience Label: Education Level Group: Audnce Data: <searchLink fieldCode="EL" term="%22Junior+High+Schools%22">Junior High Schools</searchLink><br /><searchLink fieldCode="EL" term="%22Middle+Schools%22">Middle Schools</searchLink><br /><searchLink fieldCode="EL" term="%22Secondary+Education%22">Secondary Education</searchLink> – Name: Subject Label: Descriptors Group: Su Data: <searchLink fieldCode="DE" term="%22Adolescents%22">Adolescents</searchLink><br /><searchLink fieldCode="DE" term="%22Middle+School+Students%22">Middle School Students</searchLink><br /><searchLink fieldCode="DE" term="%22Well+Being%22">Well Being</searchLink><br /><searchLink fieldCode="DE" term="%22Intervention%22">Intervention</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+Health%22">Mental Health</searchLink><br /><searchLink fieldCode="DE" term="%22Health+Promotion%22">Health Promotion</searchLink><br /><searchLink fieldCode="DE" term="%22Psychology%22">Psychology</searchLink><br /><searchLink fieldCode="DE" term="%22Program+Evaluation%22">Program Evaluation</searchLink><br /><searchLink fieldCode="DE" term="%22Program+Effectiveness%22">Program Effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+Health+Programs%22">Mental Health Programs</searchLink><br /><searchLink fieldCode="DE" term="%22Program+Implementation%22">Program Implementation</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Attitudes%22">Student Attitudes</searchLink> – Name: DOI Label: DOI Group: ID Data: 10.1002/pits.23488 – Name: ISSN Label: ISSN Group: ISSN Data: 0033-3085<br />1520-6807 – Name: Abstract Label: Abstract Group: Ab Data: ABSTRACT Many youth seek and receive mental health treatment in schools, yet research on their perceptions of these interventions remains uncommon. This qualitative study explored how student perspectives on social validity informed the ongoing implementation and evaluation of the Well-Being Promotion Program (WBPP), a Tier 2 positive psychology intervention in middle schools. The study was conducted during the initial years of a larger ongoing randomized control trial evaluating the WBPP's effectiveness. Themes from student interviews conducted during Year 1 of the larger study were used to inform implementation supports during Year 2 to enhance student acceptability. Thirty student interviews were conducted during Year 2 of the larger study. Overall, most students found the intervention content, group process, and delivery to be acceptable. The findings identified ways to further enhance the implementation of the WBPP and indicate accessing student voice is an important way to engage in program implementation and evaluation of a middle school-based intervention. Recommendations are provided for those interested in centering student voices regarding social validity to inform program implementation and evaluation. – Name: AbstractInfo Label: Abstractor Group: Ab Data: As Provided – Name: DateEntry Label: Entry Date Group: Date Data: 2025 – Name: AN Label: Accession Number Group: ID Data: EJ1477351 |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1477351 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1002/pits.23488 Languages: – Text: English PhysicalDescription: Pagination: PageCount: 13 StartPage: 2630 Subjects: – SubjectFull: Adolescents Type: general – SubjectFull: Middle School Students Type: general – SubjectFull: Well Being Type: general – SubjectFull: Intervention Type: general – SubjectFull: Mental Health Type: general – SubjectFull: Health Promotion Type: general – SubjectFull: Psychology Type: general – SubjectFull: Program Evaluation Type: general – SubjectFull: Program Effectiveness Type: general – SubjectFull: Mental Health Programs Type: general – SubjectFull: Program Implementation Type: general – SubjectFull: Student Attitudes Type: general Titles: – TitleFull: Centering Adolescents' Voices: Informing a Middle School-Based Well-Being Intervention Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Sarah Kiefer – PersonEntity: Name: NameFull: Jacqueline Blass – PersonEntity: Name: NameFull: Sarah Fefer – PersonEntity: Name: NameFull: Kai Zhuang Shum – PersonEntity: Name: NameFull: Kristen Mahony-Atallah – PersonEntity: Name: NameFull: Shannon Suldo – PersonEntity: Name: NameFull: John Ferron IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 08 Type: published Y: 2025 Identifiers: – Type: issn-print Value: 0033-3085 – Type: issn-electronic Value: 1520-6807 Numbering: – Type: volume Value: 62 – Type: issue Value: 8 Titles: – TitleFull: Psychology in the Schools Type: main |
| ResultId | 1 |
